Flexible antenna for stimulator

ABSTRACT

An implant includes a housing that houses circuitry that is electrically coupled to one or more electrodes. The implant includes an antenna that is electrically coupled to the circuitry. The antenna has a pre-treatment state in which the antenna is not shaped to receive wireless power for treating a subject, and a treatment state in which the antenna is shaped to receive wireless power and to anchor the implant with respect to a nerve of the subject. Other embodiments are also described.

FIELD OF THE INVENTION

Some applications of the present invention relate in general to medical implants. More specifically, some applications of the present invention relate to neurostimulator implants.

BACKGROUND

U.S. Pat. No. 8,788,045 to Gross et al., which is incorporated herein by reference, describes identifying a subject as suffering from polyneuropathy. In response to the identifying, electrodes are placed within 1 mm of a tibial nerve of the subject, the electrodes being disposed on a housing that is at least partially flexible. The electrodes are driven to treat the polyneuropathy by driving a current into the tibial nerve.

U.S. Pat. No. 9,713,707 to Oron et al. which is incorporated herein by reference, describes an electrostimulator implant that comprises (i) an implant body, the implant being injectable into tissue of a subject along a longitudinal axis of the implant body, (ii) first and second electrodes, disposed on respective first and second portions of the implant body, (iii) circuitry, disposed inside the implant body, and configured to drive the electrodes to apply current to the tissue, and (iv) a mesh, disposed over at least 50 percent of the implant body, and configured to serve as an anchor of the implant.

U.S. Pat. No. 10,124,178 to Oron et al., which is incorporated by reference, describes an implant that comprises: (a) an implant body that comprises: (i) at least a first longitudinal portion of the implant body that defines a given outer diameter; and (ii) a recessed longitudinal portion of the implant body that is radially recessed with respect to the first longitudinal portion of the implant body, such that an outer diameter of the recessed longitudinal portion is less than the outer diameter of the first longitudinal portion; and (b) a cuff coupled to the implant body around the recessed longitudinal portion of the implant body such that an outer diameter of the cuff does not exceed the outer diameter of the first longitudinal portion. The cuff defines a plurality of holes that are configured to facilitate anchoring of the implant body with respect to the subject's tissue, by facilitating tissue growth into the holes.

SUMMARY OF THE INVENTION

Applications of the present invention are directed to apparatus and methods for treating a subject using an electrostimulator implant.

Typically, the implant comprises circuitry that is electrically coupled to an antenna and to electrodes. Wireless power received using the antenna is used by the circuitry to drive the electrodes to treat the subject by applying a current to a nerve of the subject. For some applications, the antenna has a pre-treatment state and a treatment state. While the antenna is in the pre-treatment state, the antenna is not shaped to receive wireless power. While the antenna is in the treatment state, the antenna is shaped to receive wireless power, and to anchor the implant with respect to the nerve.

For some such applications, the antenna is coupled to a spring. The antenna and the spring act together as a tissue anchor that receives wireless power and that anchors the implant with respect to the nerve. Typically for such applications, expansion of the spring from a compressed state to an expanded state causes the antenna to transition from the pre-treatment state to the treatment state.

For some such applications, the antenna has a sliding end, and transition of the antenna from a non-anchoring, pre-treatment state to an anchoring, treatment state causes the sliding end to slide along the implant.

For some applications, an implant is provided that includes a housing on which the electrodes are disposed, and an anchor that includes (i) a sleeve within which a portion of the housing is disposed, (ii) a base within which a portion of the antenna is disposed, and (iii) an envelope that is openable and closable around a portion of a nerve of the subject. By closing the envelope around the nerve, the electrodes are held adjacent to the nerve.

There is therefore provided, in accordance with an application of the present invention, an apparatus including an implant, the implant including:

one or more electrodes;

circuitry that is electrically coupled to the electrodes;

a housing that houses the circuitry; and

an antenna that is electrically coupled to the circuitry, the antenna having:

-   -   a pre-treatment state in which the antenna is not shaped to         receive wireless power for treating a subject, and     -   a treatment state in which the antenna is shaped to receive         wireless power for treating the subject and to anchor the         implant with respect to a nerve of the subject.

In an application, the apparatus includes an injector configured to house the implant and to hold the antenna in the pre-treatment state.

In an application, the housing is shaped to define a feedthrough by which the antenna is electrically coupled to the circuitry.

In an application:

the one or more electrodes include at least an anode and a cathode,

the implant defines a longitudinal axis, and

at least a portion of the antenna spans a longitudinal distance along the housing from the anode to the cathode.

In an application, the apparatus includes a spring, the spring:

coupled to the antenna,

having a compressed state and an expanded state, and

configured to cause the antenna to transition from the pre-treatment state to the treatment state by expanding from the compressed state to the expanded state.

In an application, the spring is produced by attaching a plurality of spring segments to each other.

In an application:

the implant defines a longitudinal axis,

the antenna has:

-   -   a fixed end at which the antenna is electrically coupled to the         circuitry, and     -   a sliding end that is slidable along the longitudinal axis, with         respect to the housing, and

the spring is configured to cause the antenna to transition from the pre-treatment state to the treatment state by sliding the sliding end of the antenna toward the fixed end of the antenna.

In an application, the spring and the antenna are configured to act together as a tissue anchor for anchoring the implant to tissue of the subject, the tissue anchor being configured to (i) receive wireless power, and (ii) anchor the implant with respect to the nerve.

In an application:

one of the electrodes is disposed on and rigidly coupled to the housing, and

another one of the electrodes is coupled to the tissue anchor and flexibly coupled to the housing.

There is further provided, in accordance with an application of the present invention, an apparatus for use with a nerve of a subject, the apparatus including:

an implant, the implant including:

-   -   one or more electrodes;     -   an antenna;     -   circuitry that is electrically coupled to (a) the electrodes         and (b) the antenna;     -   a housing that houses the circuitry; and     -   an anchor including (a) a base within which a portion of the         antenna is disposed and (b) a sleeve, a portion of the housing         disposed within the sleeve.

In an application, the housing is shaped to define a feedthrough by which the antenna is electrically coupled to the circuitry.

In an application:

the anchor is shaped to define an envelope, the envelope:

-   -   having an open state and a closed state,     -   configured to transition from the open state to the closed state         while the implant is positioned adjacent to a portion of the         nerve, such that:         -   while the envelope is in the open state, the implant is             positionable adjacent to a portion of the nerve, and         -   while the envelope is in the closed state, the envelope at             least partially encloses:         -   the portion of the nerve, and         -   the housing.

In an application:

the implant is shaped to define a longitudinal axis, and

the implant is positionable adjacent to the portion of the nerve such that the portion of the nerve is disposed along the longitudinal axis.

In an application, the envelope is shaped to define an arm.

In an application, a portion of the arm is coupled to the base.

In an application, a portion of the arm is coupled to an outer surface of the sleeve.

There is further provided, in accordance with an application of the present invention, a method including:

implanting an implant adjacent to a nerve of a subject, the implant including:

-   -   one or more electrodes,     -   circuitry that is electrically coupled to the electrodes,     -   a housing that houses the circuitry, and     -   an antenna that is electrically coupled to the circuitry, the         antenna shaped in a pre-treatment state in which the antenna is         not shaped to receive wireless power for treating the subject;         and

causing the antenna to transition from the pre-treatment state into a treatment state in which the antenna is shaped to receive wireless power for treating the subject and to anchor the implant with respect to the nerve.

In an application:

the electrodes include at least a cathode and an anode,

the cathode is disposed on the housing,

the nerve is disposed in a vicinity of fascia having a superficial side and a deep side, and

the step of implanting includes implanting the implant such that:

-   -   the antenna is disposed on the superficial side of the fascia,         and     -   the cathode is disposed on the deep side of the fascia.

In an application, causing the antenna to transition from the pre-treatment state into the treatment state includes expanding the antenna from a non-anchoring state into an anchoring state.

In an application:

the implant defines a longitudinal axis,

the antenna has:

-   -   a fixed end at which the antenna is electrically coupled to the         circuitry, and     -   a sliding end; and

the step of expanding includes sliding the sliding end of the antenna along the longitudinal axis.

In an application:

the implant includes a spring, the spring:

-   -   coupled to the antenna, and     -   having a compressed state and an expanded state, and

causing the antenna to transition from the pre-treatment state into the treatment state includes causing the spring to expand from the compressed state to the expanded state.

In an application:

the implant defines a longitudinal axis,

the antenna has:

-   -   a fixed end at which the antenna is electrically coupled to the         circuitry, and     -   a sliding end that is slidable along the longitudinal axis, with         respect to the housing, and     -   causing the antenna to transition from the pre-treatment state         into a treatment state includes sliding the sliding end of the         antenna toward the fixed end of the antenna.

In an application:

the antenna and the spring are configured to act together as a tissue anchor for anchoring the implant to tissue of the subject,

one of the electrodes is disposed on and rigidly coupled to the housing, and

another one of the electrodes is coupled to the tissue anchor and flexibly coupled to the housing.

There is further provided, in accordance with an application of the present invention, a method, including:

implanting an implant adjacent to a nerve of a subject, the implant including:

-   -   one or more electrodes;     -   an antenna;     -   circuitry that is electrically coupled to (a) the electrodes         and (b) the antenna;     -   a housing that houses the circuitry; and     -   an anchor including (a) a base within which a portion of the         antenna is disposed and (b) a sleeve, a portion of the housing         disposed within the sleeve, and         the step of implanting includes positioning the implant such         that a base-plane defined by the base is generally parallel to a         longitudinal axis defined by a portion of the nerve.

In an application:

the anchor includes an envelope, the envelope having an open state and a closed state,

the step of implanting includes:

-   -   opening the envelope into the open state, such that the step of         positioning includes positioning the implant adjacent to the         portion of the nerve while the envelope is in the open state,         and     -   closing the envelope into the closed state, such that the         envelope at least partially encloses:         -   the portion of the nerve, and         -   the housing.

In an application:

the envelope is shaped to define an arm,

the step of opening the envelope includes extending a portion of the arm away from the base.

In an application, the portion of the arm is a first portion of the arm, and the arm has a second portion that is coupled to the base.

In an application, the portion of the arm is a first portion of the arm, and the arm has a second portion that is coupled to an outer surface of the sleeve.

The present invention will be more fully understood from the following detailed description of applications thereof, taken together with the drawings, in which:

BRIEF DESCRIPTION OF THE DRAWINGS

FIGS. 1A-F, 2A-B, 3A-B and 4A-B are schematic illustrations showing electrostimulator implants and implantation thereof for treating a subject, in accordance with some applications of the present invention;

FIGS. 5A-B, 6A-B and 7A-B are schematic illustrations showing electrostimulator implants for treating a subject, in accordance with some applications of the present invention; and

FIGS. 8-9 are schematic illustrations showing electrostimulator implants and implantation thereof for treating a subject, in accordance with some applications of the present invention.

DETAILED DESCRIPTION OF EMBODIMENTS

Reference is made to FIGS. 1A-F and 2A-B, which are schematic illustrations showing electrostimulator implants 20, 20′ and implantation thereof for treating a subject, in accordance with some applications of the invention.

FIGS. 1A-B show implant 20 having been implanted at two exemplary implantation locations, in accordance with some applications of the invention. In each example shown, implant 20 is positioned adjacent a nerve 14 (e.g., a hypoglossal nerve in FIG. 1A, or a tibial nerve in FIG. 1B) of the subject. In this way, implant 20 may be used to provide electrostimulation to the nerve, as described hereinbelow. Typically, but not necessarily, implant 20 (e.g., a cathode 54 thereof), as well as other implants described hereinbelow, are positioned adjacent, but not touching nerve 14. In this way, care is taken to reduce application of force by the implant to the nerve.

As shown in FIGS. 1C-D, implant 20 comprises one or more electrodes 50 (e.g., cathode 54 and an anode 52) and circuitry 22 that is housed within a housing 40. Circuitry 22 is typically electrically coupled to an antenna 34, e.g., via feedthroughs 70, and to electrodes 50. In this way, the wireless power that is received using antenna 34 is used by circuitry 22 to drive electrodes 50 to treat the subject by applying a current to nerve 14. Typically, antenna comprises a biocompatible, flexible, highly conductive material, e.g., gold.

For some applications, and as shown, feedthroughs 70 are disposed on a portion of housing 40 (e.g., endcap 42 thereof) that is closer to anode 52 (e.g., adjacent to the anode) than to cathode 54. Alternatively, feedthroughs may be disposed on a portion of housing 40 (e.g., endcap 42 thereof) that is closer to cathode 54 (e.g., adjacent to the cathode) than to anode 52, mutatis mutandis.

FIG. 1C shows implant 20 housed within an injector 100 that holds antenna 34 in a pre-treatment state, and FIG. 1D shows the antenna in a treatment state, after release of the implant from the injector. Typically, while antenna 34 is shaped in the pre-treatment state, the antenna is not shaped to receive wireless power for treating the subject. While antenna 34 is in the treatment state, the antenna is shaped to receive wireless power, and to anchor implant 20 with respect to nerve 14.

Although antenna 34 may be capable of receiving a certain amount of wireless power while shaped in the pre-treatment state, the antenna is capable of receiving wireless power more efficiently when the antenna is shaped in the treatment state, due to its larger receiving area. Antenna 34 may therefore be said to be shaped to receive wireless power when shaped in the treatment state.

For some applications, and as shown, antenna 34 is coupled (e.g., using sutures 36) to a spring 32. In this way, the antenna and the spring act together as a tissue anchor 30 that (i) receives wireless power and (ii) anchors implant 20 with respect to nerve 14. For some such applications, spring 32 causes the antenna to transition from the pre-treatment state to the treatment state when the spring expands (e.g., upon release from injector 100) from a compressed state to an expanded state.

For some applications, and as shown in FIGS. 1E-F, implant 20 is implanted adjacent to nerve 14. As shown, fascia 12 has a superficial side 12 a that is closer to skin 10 of the subject, and a deep side 12 b that is closer to nerve 14. For the sake of clarity, other types of tissue (e.g., muscle and adipose tissue) are not shown in these schematic illustrations.

For some such applications, it may be desirable to implant the implant such that tissue anchor 30 is disposed on superficial side 12 a of fascia 12 while at least one of the electrodes (e.g., cathode 54) is disposed on deep side 12 b of the fascia, adjacent the nerve. For example, and as shown in FIG. 1E, a portion of housing 40 (e.g., a portion of anode 52 that is disposed on the housing) may also be disposed on superficial side 12 a of fascia 12. Alternatively, both anode 52 and cathode 54 may be disposed on deep side 12 b of fascia 12 (FIG. 1F) and/or generally equidistant from nerve 14.

FIGS. 2A-B show an implant 20′ that is generally identical to implant 20, except for tissue anchor 30′. Similarly to tissue anchor 30, tissue anchor 30′ comprises an antenna 34′ that is coupled (e.g., by sutures 36) to a spring 32′. For some applications and as shown, spring 32′ comprises a plurality of spring segments 32 a′, 32 b′. For example and as shown, spring 32′ may be assembled by attaching the spring segments (e.g., by soldering, welding, or using an adhesive adhesive) to each other at a coupling point 33′ of spring 32′. In this way, when spring 32′ is compressed (e.g., when implant 20′ is compressed into the injector), the spring typically folds at coupling point 33′, which facilitates higher compression without applying strong bending forces at a small region of the spring. When implant 20′ is released from the injector, spring 32′ typically expands by unfolding at coupling point 33′, which increases predictability of the expansion.

Further similarly to implant 20, antenna 34′ of implant 20′ is typically coupled to circuitry 22 via feedthroughs 70. For some applications, and as shown, feedthroughs 70 are disposed on a portion of housing 40 (e.g., endcap 42 thereof) that is closer to anode 52 (e.g., adjacent to the anode) than to cathode 54. Alternatively, feedthroughs may be disposed on a portion of housing 40 (e.g., endcap 42 thereof) that is closer to cathode 54 (e.g., adjacent to the cathode) than to anode 52, mutatis mutandis.

Reference is made to FIGS. 3A-B and 4A-B, which are schematic illustrations showing electrostimulator implants 120, 220 and implantation thereof for treating a subject, in accordance with some applications of the invention.

Similarly to implant 20, implants 120, 220 comprise circuitry 122, 222 that is housed within a housing 140, 240. Circuitry 122 is typically electrically coupled to an antenna 134, 234, e.g., via feedthroughs 170 a, 270, and to electrodes 150, 250 (e.g., to an anode 152, 252 and a cathode 154, 254).

Implants 120, 220 are shown while antennas 134, 234 are in a treatment state in which antenna is shaped to receive wireless power. In this way, the wireless power that is received by antenna 134, 234 is used by circuitry 122, 222 to drive electrodes 150, 250 to treat the subject by applying a current to nerve 14. FIGS. 3B and 4B show implants 120, 220 having been implanted on deep side 12 b of fascia 12, adjacent to nerve 14.

For some applications and as shown, antenna 134, 234 is coupled (e.g., using sutures 36) to a spring 132, 232. As shown, the antenna and the spring act together as a tissue anchor 130, 230 that (i) receives wireless power and (ii) anchors implant 120, 220 with respect to nerve 14.

For some applications and as shown, both antennas 134, 234 extend along a portion of housing 140, 240. For example, and as shown, at least a portion of antenna 134, 234 spans a longitudinal distance from anode 152, 252 to cathode 154, 254.

Implants 120, 220 differ from each other in terms of the location of electrodes 150. Similarly to implants 20, 20′, electrodes 250 of implant 220 are both disposed on housing 240. In contrast, one electrode 150 (e.g., anode 152, as shown in FIG. 3A) is disposed on and rigidly coupled to housing 140, whereas the other electrode 150 (e.g., cathode 154, as shown) is coupled to anchor 130, e.g., on spring 132 thereof, and therefore flexibly coupled to the housing. It is hypothesized by the inventor that one of the electrodes (e.g., cathode 154, as shown) being flexibly coupled to housing 140 inhibits undesirable application of mechanical force from the electrode to nerve 14, e.g., during implantation of implant 120 or after implantation thereof.

As shown in FIG. 3A, cathode 154 is electrically coupled to circuitry 122 by wire 172, which is connected (i) to the cathode, and (ii) via a feedthrough 170 b to the circuitry. In contrast to implant 120, circuitry 222 of implant 220 (FIG. 4A) is coupled to electrodes 250 from within housing 240, such that implant 220 utilizes feedthroughs 270 to connect antenna 234 to the circuitry, but does not utilize feedthroughs to couple electrodes 250 to the circuitry.

For some applications, and as shown, feedthroughs 270 are disposed on a portion of housing 240 (e.g., endcap 242 thereof) that is closer to cathode 254 (e.g., adjacent to the cathode) than to anode 252. Alternatively, feedthroughs 270 may be disposed on a portion of housing 240 (e.g., endcap 242 thereof) that is closer to anode 252 (e.g., adjacent to the anode) than to cathode 254, mutatis mutandis.

Reference is made to FIGS. 5A-B, 6A-B and 7A-B, which are schematic illustrations showing electrostimulator implants 320, 420, 420′, in accordance with some applications of the invention.

By way of illustration, FIG. 5A shows implant 320 housed within injector 100 with antenna 334 shaped in a pre-treatment state, and FIGS. 6A and 7A show implants 420, 420′ having been released from the injector, with antenna 434 at a point of transition from the pre-treatment state to a treatment state (FIGS. 5B, 6B, 7B). A period of time following release from the injector (e.g., several hours, days or weeks) during which antenna 434, 434′ transitions to the state shown in FIGS. 6A and 7A may be determined by several factors, including mechanical resistance that tissue surrounding the implants apply to the implants, as well as shape-memory characteristics of springs 432, 432′.

Similarly to implants 20, 120, 220, implants 320, 420, 420′ comprise circuitry 322, 422 that is housed within a housing 340, 440. Circuitry 322, 422 is typically electrically coupled to an antenna 334, 434, e.g., via feedthroughs 370, 470, and to electrodes 350, 450 (e.g., to an anode 352, 452 and a cathode 354, 454, as shown). In this way, the wireless power that is received using antenna 334, 434 is used by circuitry 322, 422 to drive electrodes 350, 450 to treat the subject by applying a current to nerve 14.

As shown, and similarly to as described hereinabove with reference to implants 120, 220, antenna 334, 434 extends along a portion of housing 340. However, in contrast to the embodiments of implants 120, 220 described hereinabove, antennas 334, 434 each comprise (i) a sliding end 356, 456 that is slidable along a longitudinal axis ax300, ax400 of implant 320, 420, 420′, and (ii) a fixed end at which the antenna is electrically coupled to circuitry 322, 422 (e.g., via feedthroughs 370, 470).

Typically for such applications, transition of antenna 334, 434 from a non-anchoring, pre-treatment state to an anchoring, treatment state causes sliding end 356, 456 of antenna 334, 434 to slide along axis ax300, ax400. For example, sliding end 356, 456 may be a ring that surrounds and slides along housing 340, 440 with respect to electrodes 350, 450.

For some such applications and as shown, the fixed end of antenna 334, 434 is disposed at a portion of housing 340, 440 (e.g., at an endcap 342, 442 thereof) that is closed to anode 352, 452 than to cathode 354, 454. Typically for such applications, and as shown in FIGS. 5B, 6B, 7B, sliding end 356, 456 slides away from cathode 354, 454 as antenna 334, 434 expands. Alternatively, the fixed end of antenna 334, 434 may be disposed at a portion of housing 340, 440 (e.g., at endcap 342, 442 thereof) that is closed to cathode 354, 454 than to anode 352, 452, such that sliding end 356, 456 slides away from the anode as the antenna expands.

For some applications, and as shown in FIGS. 5A-B, antenna 334 may be coupled (e.g., using sutures 36) to a spring 332. In this way, antenna 334 and spring 332 act together as a tissue anchor 330 that (i) receives wireless power and (ii) anchors implant 320 with respect to nerve 14.

Implant 420 differs from implant 320 in that tissue anchor 430 typically comprises a greater number of springs 432. As shown, springs 432 of implant 420 are arranged to be generally parallel to longitudinal axis ax400. Whereas springs 432 are shown in FIG. 6B such that each spring is generally circumferentially equidistant from each other, the springs are typically sufficiently flexible such that when implant 420 is implanted into tissue, the springs may conform to the shape of the tissue due to the mechanical resistance that different types and/or layers of tissue offer. For example, flexibility of springs 432 may facilitate anchoring of implant 420 between different tissue layers (e.g., between skin 10 and fascia 12 or between the fascia and nerve 14, as shown hereinabove with respect to implants 20, 120, 220).

FIGS. 7A-7B show implant 420′, which is generally similar to implant 420, with certain differences between tissue anchors 430, 430′. As shown, tissue anchor 430′ comprises a flexible mesh 435. It is hypothesized by the inventor that mesh 435 may facilitate ingrowth of tissue onto the mesh, thereby further facilitating anchoring of implant 420′ within the tissue (e.g., by means of fibrosis developing in the mesh).

For some applications, mesh 435 is elastic, such that the mesh, together with spring 432, causes antenna 434 to transition from the pre-treatment state to the treatment state when the mesh expands (e.g., upon release from the injector 100) from a compressed state to an expanded state.

For some applications, mesh 435 is sufficiently elastic such that expansion of the mesh alone may cause antenna 434 to transition from the pre-treatment state to the treatment state. For some such applications, implant 420 may therefore comprise mesh 435 but not spring 432.

For some applications and as shown, tissue anchor 430′ comprises mesh 435 and antenna 434, which is electrically coupled to circuitry 422 through feedthroughs 470.

For some applications, antenna 434 is integrated into mesh 435, thereby obviating the discrete antenna 434 shown in FIGS. 7A-B.

Reference is made to FIGS. 8-9 , which are schematic illustrations showing electrostimulator implants 820 and 920 and implantation thereof for treating a subject, in accordance with some applications of the invention.

As shown, implants 820, 920 comprise an anchor 860, 960, as well as a housing 840, 940 on which electrodes 850, 950 are disposed. Typically, and as shown, housing 840, 940 defines a longitudinal axis ax800, ax900 along which electrodes 850, 950 are disposed.

Similarly to the implants described hereinabove, implants 820, 920 comprise circuitry (not shown) that is housed by housing 840, 940. The circuitry is electrically coupled to an antenna 834, 934 (e.g., via feedthroughs 870, 970) and to electrodes 850, 950, such that wireless power received using the antenna is used by the circuitry to drive electrodes 850, 950 to treat the subject by applying a current to nerve 14.

Typically, and as shown, anchor 860, 960 is configured to anchor the implant (e.g., electrodes 850, 950 thereof) adjacent to nerve 14. Anchor 860, 960 comprises a base 862, 962 within which a portion of antenna 834, 934 is disposed. For some applications, and as shown, most or all of a length of antenna 834, 934 is disposed within base 862, 962.

Anchor 860, 960 further comprises a sleeve 864, 964 within which a portion of housing 840, 940 is disposed. Typically, electrodes 850, 950 are not disposed within sleeve 864, 964 (or if thus disposed, are exposed to surrounding tissue through a window (not shown) in the sleeve). In this way, sleeve 864, 964 holds housing 840, 940, and therefore electrodes 850, 950 adjacent to nerve 14, yet the sleeve typically does not separate between the electrodes and the nerve, thereby facilitating application of current from the electrodes to the nerve.

For some applications, and as shown, anchor 860, 960 is shaped to define an envelope 866, 966 that has an open state and a closed state. Typically for such applications, envelope 866, 966 comprises a flexible, biocompatible material, e.g., silicone, such that the envelope may be readily opened and closed. For some such applications and as shown, envelope 866, 966 is shaped to define an arm. For example, the arm may be coupled to sleeve 864, 964 (FIGS. 8-9 ) and/or to base 962 (FIG. 9 ).

While envelope 866, 966 is open, anchor 860, 960 (e.g., a side of base 862, 962 on which sleeve 864, 964 is disposed) is positioned adjacent to a portion of nerve 14. Typically, implant 820, 920 is positioned such that a base-plane defined by base 862, 962 is generally parallel to a longitudinal axis defined by the portion of the nerve.

Envelope 866, 966 is then caused to transition (e.g., the arm is released) from the open state to the closed state, such that the envelope at least partially encloses nerve 14, and the portion of the nerve is disposed along axis ax800, ax900. (FIGS. 8-9 ).

It will be noted that the methods and apparatus described herein may be used in combination with those described in the following:

-   -   U.S. Pat. No. 8,788,045 to Gross et al.     -   U.S. Pat. No. 9,713,707 to Oron et al.     -   U.S. Pat. No. 10,124,178 to Oron et al.

It will be appreciated by persons skilled in the art that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof that are not in the prior art, which would occur to persons skilled in the art upon reading the foregoing description. 

1. Apparatus comprising an implant, the implant comprising: one or more electrodes; circuitry that is electrically coupled to the electrodes; a housing that houses the circuitry; and an antenna that is electrically coupled to the circuitry, the antenna having: a pre-treatment state in which the antenna is not shaped to receive wireless power for treating a subject, and a treatment state in which the antenna is shaped to receive wireless power for treating the subject and to anchor the implant with respect to a nerve of the subject.
 2. The apparatus according to claim 1, further comprising an injector configured to house the implant and to hold the antenna in the pre-treatment state.
 3. The apparatus according to claim 1, wherein the housing is shaped to define a feedthrough by which the antenna is electrically coupled to the circuitry.
 4. The apparatus according to claim 1, wherein: the one or more electrodes comprise at least an anode and a cathode, the implant defines a longitudinal axis, and at least a portion of the antenna spans a longitudinal distance along the housing from the anode to the cathode.
 5. The apparatus according to claim 1, further comprising a spring, the spring: coupled to the antenna, having a compressed state and an expanded state, and configured to cause the antenna to transition from the pre-treatment state to the treatment state by expanding from the compressed state to the expanded state.
 6. The apparatus according to claim 5, wherein the spring is produced by attaching a plurality of spring segments to each other.
 7. (canceled)
 8. The apparatus according to claim 5, wherein the spring and the antenna are configured to act together as a tissue anchor for anchoring the implant to tissue of the subject, the tissue anchor being configured to (i) receive wireless power, and (ii) anchor the implant with respect to the nerve.
 9. The apparatus according to claim 8, wherein: one of the electrodes is disposed on and rigidly coupled to the housing, and another one of the electrodes is coupled to the tissue anchor and flexibly coupled to the housing. 10-16. (canceled)
 17. A method comprising: implanting an implant adjacent to a nerve of a subject, the implant including: one or more electrodes, circuitry that is electrically coupled to the electrodes, a housing that houses the circuitry, and an antenna that is electrically coupled to the circuitry, the antenna shaped in a pre-treatment state in which the antenna is not shaped to receive wireless power for treating the subject; and causing the antenna to transition from the pre-treatment state into a treatment state in which the antenna is shaped to receive wireless power for treating the subject and to anchor the implant with respect to the nerve.
 18. The method according to claim 17, wherein: the electrodes include at least a cathode and an anode, the cathode is disposed on the housing, the nerve is disposed in a vicinity of fascia having a superficial side and a deep side, and the step of implanting comprises implanting the implant such that: the antenna is disposed on the superficial side of the fascia, and the cathode is disposed on the deep side of the fascia.
 19. The method according to claim 17, wherein causing the antenna to transition from the pre-treatment state into the treatment state comprises expanding the antenna from a non-anchoring state into an anchoring state.
 20. (canceled)
 21. The method according to claim 17, wherein: the implant further comprises a spring, the spring: coupled to the antenna, and having a compressed state and an expanded state, and causing the antenna to transition from the pre-treatment state into the treatment state comprises causing the spring to expand from the compressed state to the expanded state.
 22. (canceled)
 23. The method according to claim 21, wherein: the antenna and the spring are configured to act together as a tissue anchor for anchoring the implant to tissue of the subject, one of the electrodes is disposed on and rigidly coupled to the housing, and another one of the electrodes is coupled to the tissue anchor and flexibly coupled to the housing. 24-28. (canceled)
 29. The method according to claim 17, wherein the antenna extends longitudinally away from the housing, both when the antenna is in the pre-treatment state and in the treatment state.
 30. The method according to claim 29, when the housing comprises an endcap that defines one end of the housing, and wherein the antenna is coupled to the endcap extending longitudinally away from the endcap.
 31. The apparatus according to claim 1, wherein the antenna extends longitudinally away from the housing, both when the antenna is in the pre-treatment state and in the treatment state.
 32. The apparatus according to claim 31, when the housing comprises an endcap that defines one end of the housing, and wherein the antenna is coupled to the endcap extending longitudinally away from the endcap. 